As if getting some quality shut-eye during pregnancy wasn’t hard enough, what with pregnancy-related symptoms like the frequent trips to the bathroom, heartburn, and leg cramps, yet another pregnancy symptom that interferes with sleep might strike in the third trimester: restless legs syndrome. Affecting around a third of pregnant women, restless legs syndrome presents as a disconcerting tingling in your legs and feet and is often accompanied by an urge to move them. It can often feel like your legs and feet have a life of their own.
What causes restless legs syndrome?
Experts aren’t exactly sure about what causes the strange sensations in your legs due to restless legs syndrome, but there are a few different hypotheses floating around out there (for an in-depth review of this topic, see the article by Dr. Chris Iliades published in The Pulse here). One of these is that restless legs syndrome is caused by an imbalance in levels of a chemical called dopamine. Dopamine usually helps keep muscle movements smooth and controlled. Another possibility is that it is caused by a deficiency in either iron or folic acid. There is also some evidence that restless legs syndrome may be caused by rising levels of estrogen during pregnancy. This would explain why it occurs most often in the third trimester, when estrogen levels are at their highest.
Interestingly, restless legs syndrome may be associated with how many children you have previously given birth to. A study in Germany found that the risk of restless legs syndrome was ever increasing with women who had given birth to one, two, or three children, compared with women who had never given birth before.
What can I do about restless legs syndrome?
For mild restless legs syndrome, you could try soaking in a warm (not hot) bath or heating pad or ice pack to try to relieve the symptoms. Yoga, meditation, and other relaxation techniques are also worth a try. If these don’t work and/or your symptoms are keeping you awake at night, it is time to make an appointment to see your doctor.
The first thing your doctor will probably check you for is an iron deficiency. If it turns out that your iron levels are low, an iron supplement to be taken regularly during your pregnancy will usually be recommended. In many cases of restless legs syndrome in women with low levels of iron, a supplement will be effective in reducing the symptoms.
Unfortunately treating restless legs syndrome with medication is challenging because most of the drugs used to typically treat it, such as Requip (ropinirole) or Mirapex (pramipexole), have not been extensively tested in pregnant women.
Sedatives are also used to treat restless legs syndrome – in particular a drug called clonazepam. However, although there is no evidence that clonazepam causes major fetal abnormalities, there is evidence that it may cause minor fetal abnormalities such as cleft palate.
Another type of medication for treating restless legs syndrome is opioid (narcotic) drugs. However, due to the risk of the fetus becoming addicted to these drugs and experiencing withdrawal following birth, they can only be administered over a short period of time.
With respect to treatment approaches that don’t involve medication, the FDA has approved a device called Relaxis. Relaxis is a vibrating pad that is placed under the legs while you are in bed.
However, if nothing works, you might have to learn to live with the symptoms until your baby is born. Following the birth of your baby, your symptoms should go away within around four weeks.